PURPOSE: Kiwi fruit allergy in children has scarcely been reported. This study focused on the clinical characteristics of kiwi fruit allergy and value of kiwi specific Immunoglobulin E (IgE) antibodies in Korean children. METHODS: The study was based on a data analysis of 18 patients, who were diagnosed with clinical kiwi fruit allergy at Ajou University Hospital from June 2005 to June 2012. Clinical details were collected by medical history and telephone survey. Sera from all children were analyzed for kiwi specific IgE (ImmunoCAP) and patients with negative result were further evaluated by an enzyme linked immunosorbentassay test (ELISA) using our own made kiwi fruit extracts. RESULTS: The subjects were 10 male and 8 female with a median aged 25 months. Twelve out of 18 (66.7%) were diagnosed with angioedema or urticaria, 4 (22.2%) were diagnosed with oral allergy syndrome, 1 was presented with dyspnea, and 1 was diagnosed with anaphylaxis. Oral route of exposure (88.9%) was most common and majority of patients (88.9%) experienced clinical symptoms at the first exposure to kiwi fruit. Six out of 12 patients with urticaria showed negative result in specific IgE by ImmunoCAP, but specific IgE were detected in 2 of 6 by ELISA with our own made kiwi extract. CONCLUSION: Systemic reactions to kiwi fruit were common in Korean children, and the symptoms were frequently developed at the first time of exposure. Additional diagnostic methods would be needed for evaluation of IgE sensitization in kiwi allergic patients with negative result by ImmunoCAP.
Aged ; Anaphylaxis ; Angioedema ; Antibodies ; Child ; Dyspnea ; Enzyme-Linked Immunosorbent Assay ; Female ; Fruit ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Male ; Statistics as Topic ; Telephone ; Urticaria

BACKGROUND: Patient-controlled sedation with propofol has been shown to provide safe and effective sedation for patients undergoing surgery under local anesthesia. The purpose of this study was to evaluate the efficacy of patient-controlled sedation and analgesia with propofol and fentanyl in 17 patients undergoing cataract surgery. METHODS: An admixture of 400 mg of propofol with 100microgram of fentanyl (42 ml) was loaded into a patient-controlled analgesia pump and administered at a rate of 10 ml/hr. The lock-out time was 1 minute and the bolus dose was 1 ml. At the end of surgery, pain relief, anxiety relief and the satisfaction score were recorded on a patient questionnaire with a 1 to 10 scale. RESULTS: The sedation level varied from patient to patient and there was no incidence of oversedation. Most patients were satisfied with this anxiety and pain relieving technique (more than a score of 8). Blood pressure and arterial oxygen saturation showed minimal changes and remained within normal ranges. There were no complications except complaints of pain at infusion sites from 3 patients. CONCLUSIONS: Patient-controlled sedation and analgesia is a safe and satisfactory method for most patients undergoing cataract surgery for relieving pain and anxiety.
Analgesia* ; Analgesia, Patient-Controlled ; Anesthesia, Local ; Anxiety ; Blood Pressure ; Cataract* ; Fentanyl ; Humans ; Incidence ; Oxygen ; Propofol ; Surveys and Questionnaires ; Reference Values

The Vibrant Soundbridge (VSB) with stapes clip coupler placement at the stapes head has been used successfully to treat mixed hearing loss. Coupling between the floating mass transducer of the VSB and the stapes head is technically less demanding than incus vibroplasty and is more likely to generate a positive outcome without significantly changing residual hearing or resulting in medical or surgical complications. A 65-year-old man with bilateral mixed hearing loss and chronic otitis media underwent vibroplasty with a stapes clip coupler. Speech discrimination scores in both quiet and noise environments showed better functional gain with the VSB than with the use of a conventional hearing aid. The results of the present case show the feasibility of implanting a VSB with a stapes coupler in patients with mixed hearing loss due to chronic otitis media.
Aged ; Ear, Middle ; Head ; Hearing ; Hearing Aids ; Hearing Loss ; Hearing Loss, Mixed Conductive-Sensorineural* ; Humans ; Incus ; Noise ; Otitis Media ; Rehabilitation ; Speech Perception ; Stapes* ; Transducers

Background: Prompt insertion and placement of supraglottic airway (SGA) devices in the correct position are required to secure the airway. This meta-analysis was performed to validate the usefulness of the 90° rotation technique as compared with the standard digit-based technique for the insertion of SGA devices in anesthetized patients in terms of insertion success rate, insertion time, and postoperative complications. Methods: A literature search of PubMed, EMBASE, CENTRAL, CINAHL, Scopus, and Web of Science was conducted. Randomized controlled trials, without limitations on publication period, language, journal, or region, until July 2021, that compared the 90° rotation and the standard digit-based techniques for insertion of SGA devices in anesthetized patients were included. Results: The first-attempt (risk ratio [RR]: 1.16, 95% CI [1.09, 1.25], P < 0.001) and overall success rates (RR: 1.06, 95% CI [1.03, 1.09], P < 0.001) were significantly higher in the 90° rotation group. The insertion time was shorter in the 90° rotation group (mean difference: −4.42 s, 95% CI [−6.70, −2.15 s], P < 0.001). The incidences of postoperative sore throat (RR: 0.63, 95% CI [0.49, 0.83], P < 0.001) and blood staining (RR: 0.28, 95% CI [0.20, 0.39], P < 0.001) were lower in the 90° rotation group. Conclusions The use of the 90° rotation technique increases the success rate of SGA device insertion and decreases postoperative complications as compared with that of the standard digit-based technique in anesthetized patients.

Background: Although coronavirus disease 2019 (COVID-19) vaccines have been distributed worldwide under emergency use authorization, the real-world safety profiles of mRNA vaccines still need to be clearly defined. We aimed to identify the overall incidence and factors associated with adverse events (AEs) following mRNA COVID-19 vaccination. Methods: We conducted web-based survey from December 2 to 10 in 2021 with a 2,849 nationwide sampled panel. Study participants were individuals who had elapsed at least twoweeks after completing two dosing schedules of COVID-19 vaccination aged between 18–49 years. We weighted the participants to represent the Korean population. The outcome was the overall incidence of AEs following mRNA COVID-19 vaccination and associated factors.We estimated the weighted odds ratios (ORs) using multivariable logistic regression models to identify the factors associated with AEs. Results: Of the 2,849 participants (median [interquartile range] age, 35 [27–42] years; 51.6% male), 90.8% (n = 2,582) for the first dose and 88.7% (n = 2,849) for the second dose reported AEs, and 3.3% and 4.3% reported severe AEs, respectively. Occurrence of AEs was more prevalent in mRNA-1273 (OR, 2.06; 95% confidence interval [CI], 1.59–2.67 vs. BNT162b2), female sex (1.88; 1.52–2.32), and those with dermatologic diseases (2.51; 1.32–4.77). History of serious allergic reactions (1.96; 1.06–3.64) and anticoagulant medication use (4.72; 1.92–11.6) were associated with severe AEs. Conclusion Approximately 90% of participants reported AEs following mRNA COVID-19 vaccination. Substantial factors, including vaccine type (mRNA-1273), female sex, and dermatologic diseases were associated with AEs. Our findings could aid policymakers in establishing vaccination strategies tailored to those potentially susceptible to AEs.

Niemann-Pick disease is a storage disease characterized by accumulation of sphingomyelin and other lipids, mainly in the reticuloendothelial system. We experienced a case of type A Niemann-Pick disease in a 18-month-old male infant. He showed dyspnea, marked hepatosplenomegaly and developmental retardation. Fundoscopic examination revealed cherry red spots in both macula. Bone marrow aspirates showed characteristic foam cells. Autopsy finding revealed that liver, spleen, lung, lymph node and brain were involved. Reticular infiltration was shown on chest X-ray. We reported a case of type A Niemann-Pick disease with a brief review of the related literature.
Autopsy ; Bone Marrow ; Brain ; Dyspnea ; Foam Cells ; Humans ; Infant ; Liver ; Lung ; Lymph Nodes ; Male ; Mononuclear Phagocyte System ; Niemann-Pick Disease, Type A* ; Niemann-Pick Diseases ; Prunus ; Spleen ; Thorax

Ectopia cordis is a rare congenital anomaly in which the heart is situated outside the chest cavity and has been known for many years, being reported first in 1671 by Neil Stenson. Ectopia cordis appears closely related with defective embryonic development, arising as the result of defective formation and differentiation of the ventral mesoderm at 14 to 18 days of embryonic life. Ectopia cordis is usually classified into many types according to the site at which the heart protrudes: thoracic type, abdominal type, thoraco-abdominal type, cervical type. We have experinced one case of ectopia cordis which was diagnosed by ultrasonography at 16th gestational weeks in 30 year old multiparity. We report this case with brief review of literatures.
Adult ; Ectopia Cordis* ; Embryonic Development ; Female ; Heart ; Humans ; Mesoderm ; Parity ; Pregnancy ; Thorax ; Ultrasonography ; Ultrasonography, Prenatal*

BACKGROUND: There are few previous studies investigating the relationship of dental fear and anxiety (DFA) with dental pain among children and adolescents. To address this issue, we examined the literature published between November 1873 and May 2015 to evaluate the prevalence of DFA and dental pain among children and adolescents, and their relationships with age and sex. METHODS: We performed a broad search of the PubMed database using 3 combinations of the search terms dental fear, anxiety, and dental pain and prevalence. A large proportion of the identified articles could not be used for the review due to inadequate end points or measures, or because of poor study design. Thirty-two papers of acceptable quality were identified and reviewed. RESULTS: We found that the prevalence of DFA was estimated to be 10%, with a decrease in prevalence with age. It was more frequently seen in girls, and was related to dental pain. CONCLUSIONS: We concluded that dental fear, anxiety, and pain are common, and several psychological factors are associated with their development. In order to better understand these relationships, further clinical evaluations and studies are required.
Adolescent* ; Anxiety* ; Child* ; Dental Anxiety* ; Female ; Humans ; Prevalence ; Psychology

No abstract available.
Asphyxia* ; Brain* ; Humans ; Infant* ; Magnetic Resonance Imaging* ; Tomography, Emission-Computed, Single-Photon*

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder that predominantly affects women of reproductive age. Risk of SLE flare during pregnancy is dependent on disease activity of SLE and proteinuria at the time of conception, which affect pregnancy outcome. We report on three patients who developed renal flares during pregnancy after remission of lupus nephritis before pregnancy. Two patients were treated successfully, with pregnancy outcomes of live births however, another patient's pregnancy was terminated with induced abortion. For SLE patients, family planningis needed until disease activity of SLE has been stable for at least six months prior to the pregnancy. Nevertheless, flares of lupus could develop and influence maternal and fetal outcome. Therefore, renal flares during pregnancy should be recognized and treated immediately.
Abortion, Induced ; Female ; Fertilization ; Humans ; Live Birth ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Nephritis ; Pregnancy ; Pregnancy Outcome ; Pregnant Women* ; Proteinuria